Clinical Rotations/Clerkship is an exiting time for any medical graduate or student. It is the time when you actually get to deal with real patient and use your academic knowledge to treat them. The clinical clerkships are done under the guidance of an attending and their residents. Once the clerkship start, the excitement goes down and the students often regard it as incredibly stressful and high-pressure time. Where on one hand, the students were expecting to treat the patients, perform procedures and diagnose diseases, they are usually asked to run errands like get lab work, complete progress notes and just observe the procedures rather than getting the first hand experience. Well, my friends don’t get disheartened too soon, these are certain things, which are expected out of you during your rotations, but we have to make the most of it. Lets look at some of the ways in which we can maximize our clinical experience.
Make a list of the top 20 diagnoses in the department where you have been posted and read all about them. Make notes, clinically relevant notes such as most common signs, labs to be ordered, treatment to be given including the drug dosages, frequency, side effects or contraindications and how to watch for complications, which you can refer to during your clinical rounds. This help to understand the disease more effectively and ask only relevant questions which both your resident and attending will be grateful for. You can also refer to them in case the attending asks any questions and look smart. Also, make sure that you read medical histories, physician notes from the patients chart as they shall give you an insight on how to treat the patient for a particular diagnosis. Always remember that there is a huge difference between what is written in the books and what is practiced in the wards. Keep an open mind. It is also advisable to ask help from your seniors during clerkships and ask them for guidance on which resources to use for updating tour knowledge.
Look for Opportunity to Learn
The attending physician is a very busy person, he might not have time to answer your questions or teach you. Hence, shadow the residents during your clerkships. Be nice to them, ask them if you can assist in any procedures that you are scheduled for. Keep in mind that a lost opportunity never comes back. You maybe posted in a particular department for clerkship for a period of 6-12 weeks and if not don’t show interests to learn, you shall have the same experience again. Always convey a professional attitude during clerkship; this is something that the team appreciates. Don’t be late for work, wear proper clothes to work and don’t be a hindrance. If you are serious about the tasks given to you (even if it’s a menial task), more work will come your way.
Have a Balanced Approach
It is very important to have your head over your shoulders at all times during the clinical clerkships. Understand that this is your time to learn and apply your theoretical knowledge to some good for better care of the patient. As a leaner, it is very important to have a firm understanding of your strengths and weaknesses in order to optimize your clinical clerkship experience. If you don’t understand anything and you cant find the answers in the book, ASK. Don’t shy away from asking. Applying your theoretical knowledge in a clinical scenario can be really frustrating as you will never find a case as mentioned in your books. You will have symptoms on the basis of which you will have a list of differential diagnosis. Request a resident or the attending to teach you how to reach the most probable diagnosis. Medicine is trial and error but there is an art behind it which only a resident or attending can teach you because they were in your shoes once upon a time.
Every attending is a potential LOR
Humans have the inability to look at things in a long run. Don’t make this mistake. Always remember that your journey is medicine is a long one and you never know who might come at your rescue. We all require LOR at the time of matching. If you have shown good medical knowledge, appropriate bedside manners, apply evidence based medicine in patient care and completed all patient records properly during your clerkships, you might have a chance to get a fantastic LOR sometime in future from this person. This is not selfish; this is just thinking ahead proactively. A good way of thinking ahead is make a list of your objectives and appropriate strategies to achieve those objectives at the beginning of every department clinical rotations. Talk to your seniors and residents and make a list of objectives and prioritize. Clerkships are important, remember.
Enjoy the Process
This is a very important step. If you don’t enjoy your clinical clerkship experience, your patient care in future might get adversely affected. Have genuine care for the patient; be respectful towards them as they are in pain. They are your practical experience outside of books. Be respectful towards the hospital team, help them and become a good team player. Don’t be remembered for the wrong reasons.